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General NPI Number Information
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NPI Number | 1457916520
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Entity Type | Individual
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Provider Name | KIMBERLY ELMORE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/04/2019
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Last Update Date | 05/04/2019
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Provider Practice Location Address
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Address Line | 2295 N IMPERIAL AVE
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City | EL CENTRO
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State | CA
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Zip | 92243-1335
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Country | US
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Telephone | 760-482-5407
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Fax |
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Provider Business Mailing Address
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Address Line | 1540 W BARBARA WORTH DR APT 20
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City | EL CENTRO
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State | CA
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Zip | 92243-5301
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 79073
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License Number State | CA
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